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Unformatted text preview: NA ME_ STUDENT NUMBER: VERSION 1 FACULTY OF SCIENCE DEPARTMENT OF MICROBIOLOGY AND IMMUNOLOGY
Parasitology MlMM-413 I: IN AL EXAMINATION Examiner: Dr. Z. Ali-Khan Date: Thursday, April 22“, 2004
Associate Examiner: Dr. G. Faubert Time: 2:00 p.m. >l=*=I==l==i=*=l<=i<=l=>l<*****************>§==£<*=l=>l=******$************* DO NOT TURN THIS PAGE UNTIL YOU ARE TOLD TO DO SO INSTRUCTIONS Read and follow these instructions carefully: 1. Computer sheets are provided for your answers. Do not fold or bend the sheets.
2. Print your name and student number on the front of the sheet.
3. Read each question and its numbered answers. When you have decided which alternative is the BEST, mark the whole of the corresponding oval space (bubble) on your answer
sheet. Avoid making any stray marks outside the oval. You may use this question booklet
for rough work, and you may mark the alternatives when you are considering them. 4. Do not answer more than one mark for any question, otherwise the computer will reject
your sheet. If erasing, erase COMPLETELY. 5. NO PART OF THIS EXAMINATION MAY BE TAKEN OUT OF THIS ROOM
UNDER ANY CIRCUMSTANCES. 6. Marking will be on the basis of +1 mark for a correct answer; questions unanswered or
wrongly answered will be tallied as "0" when totalling your score. Three sections Time: 3 hours Total questions: 120 THIS EXAM COMPRISES 22 PAGES AND ALL MUST BE RETURNED. PLEASE INDICATE VERSION NUMBER ON ANSWER SHEET The Examination Security Monitor Program detects pairs of'studei-its with unusually Similar
answer patterns on multiple—choice exams. Data generated by this program can be used as
admissible evidence, either to initiate or corroborate an investigation or a charge of cheating
under Section 1 6 of the Code ofStiident Conduct and Disciplinary Procedures. SECTION I For each of the following multiple choice questions, choose the one correct or most
appropriate answer. 1. [\J Chemokines can attract: lymphocytes but not antigen presenting cells (APC).
APC only APC but not lymphocytes. lymphocytes and APC. neither lymphocytes nor APC. LII-DUJM— What type of inﬂammatory cell is most attracted by malaria hemozoin (HZ): T lymphocytes.
neutrOphils.
macrophages.
eosinophils. B lymphocytes. EJ'F‘E'JNr For each inﬂammatory chemokinc mentioned below, which one is associated with the
adequate receptor and function: i. TECK e CCR9 — Memory T cells, B cells, immature thymocytes.
2. CXCL16 — CXCR6 — Effector B cells. 3. Fractalkine — CX3CR1 - Liffcetor T cells. 4. Eotaxin — CCRZ e Effector T cells (TH2) 5. RANTES — CCR2 — Effector T cells (THZ) Select the wrong infection/inﬂammation related pathology match: Leishmaniasis and cutaneous lesion. Malaria and fever. Leishmaniasis and hepatosplenomegaly.
Malaria and skin lesion. Plasntodittrn falcz‘parmn and cerebral malaria. Lh-ll‘I-UJFQ— Which one (or in combination) of the following clinical feature is characteristic of
lymphaticﬁlarirzsis: deafness. enlargement of limbs and other structures.
licheniﬁeation of the skin. corneal fibrosis. none of the above. LII-[b.bJNf Within the mammalian macrophage, lea'shmania are: present in the phagolysosome as promastigotes.
present in the phagolysosome as amastigotes.
present in the cytoplasm as promastigotes.
present in the phagolysosome as epimastigotes.
present in the cytoplasm as trypomastigotes. MPPPT For each of the following multiple choice questions, choose the one correct or most
appropriate answer. 7. Infection with Let'shmrmia causes which one of the following effects on macrophages:
1. reduces macrophage viability.
2. stimulates macrophage activation.
3. induces apoptosis.
4. reduces surface MHC class II expression.
5. stimulates release of 1L-12. 8. Annotation of the Leis/mania genome DNA sequence is required to determine:
1. where the chromosomes begin and end.
2. where the genes are located and their potential function.
3. where transcription initiates on the chromosome. 4. which genes are expressed during differentiation.
5. where tranSplieing occurs.
9. Giardiasis is:
l. a food-borne disease.
2. a water-borne disease.
3. a sexually transmitted disease.
4. transmitted by person—to—person contact.
5. all of the above.
10. Which meehanism(s) is not involved in evasion by parasites:
l. escape from phagolysosome.
2. activation ofeellular immune reSponse.
3. antigen variation.
4. alteration of signaling pathways.
5. resistance to humoral immune response.
ll. The deﬁnitive diagnosis of Schistosoma niansoni ova in biopsied tissue sections is based
on
1. finding ova with a prominent lateral spine.
2. ﬁnding ova with a minute lateral spine.
3. finding ova containing a hexacanth embryo.
4. ﬁnding ova with a prominent terminal spine.
5. none of the above.
12. The definitive diagnosis of Schistosoma haematobium ova in biopsied tissue seetioris is
based on: 1. ﬁndin g ova with a prominent lateral spine. 2 ﬁnding ova With a minute lateral spine. 3. finding ova containing a hexaeanth embryo.
4 ﬁnding ova with a prominent terminal spine.
5 none of the above. For each of the following multiple choice questions, choose the one correct or most
appropriate answer. l3. 14. 15. l6. l7. l8. .Emamoeba liislolyrica cyst can be identiﬁed microscopically from that of E. coli by
certain criteria: MLMMH number of nuclei present in the cyst.
nuclear morphology. number of Sporozoites present in the cyst.
correct combination of 1 and 2. correct combination of l and 3. Plasmodium Sp belongs to the: Lh-l-‘AUJI‘QH class zoomastigophorca.
class sporozoea. class lobosea. class trematoda.
sub—class digenea. Echinoeoeeus granulosus belongs to the: mix.)— 5"}; class zoomastigophorca.
class sporozoea. class eestoidea. phylum nematoda. none of the above. Etiology of anemia in malaria includes: 9&4:ri bone marrow dyserythropoiesis.
auto-immune hemolytic anemia.
low level ofserum complement.
all the above 1, 2 and 3. only 1 and 2. Which one of the following statements is true? 2. during an infection with helminths, the stimulation of the Th1 type of cytokines
leads to immunopathology. during an infection with helminths, the stimulation of the Th2 type of cytokines
leads to immunopathology. in cerebral malaria, we have no experimental evidence showing that the cytokines
are not responsible for the pathology. TH] and TH2 types of cytokines play a role in immune expulsion of helminths
from the intestine. none of the above. One of the features of beocam infection is: .U‘P‘P’ a systemic migration of larvae in humans. direct infection by ingestion of infective larvae in aerosols released by infected
dogs. inﬂammation of the eye in humans due to deposition of eggs by migrating larvae.
inﬂammation of the skin following invasion by larvae. a systemic migration of adult worms in humans. For each of the following multiple choice questions, choose the one correct or most
appropriate answer. [9. ln children infected with Toxocam, ultrasound has been used to: I. conﬁrm serological diagnosis by ELISA. 2. confirm migration of adult Toxocara in the lungs of children.
3. identify lesions in the heart and lung. 4 conﬁnn lesions in the brain due to aberrant larval migration.
5 identify migrating adult worms in the liver. 20. Filarial worms belong to the: phylum nematoda.
phylum platyhelminthcs.
class trematoda. class cestoidea. none of the above. LAJNF- P13}- 21. Premonition observed in patients living in a malarious community is characterized by one
or a combination of the following features: 1. denotes anti-toxic immunity against malarial paroxyms.
2. is maintained as a result of continuous re~exposure to malaria infection.
3. patients show markedly low parasitaemia.
4. 1, 2, 3.
5. 1, 2.
22. Making the diagnosis of Chagas' disease may involve all of the following except:
1. searching for the trypomastigotes in a stained blood smear.
2. serology to detect antitrypanosomal antibodies.
3. tissue biopsy to demonstrate intracellular amastigotes.
4. xenodiagnosis.
5. examination of the patient's stool for metacyclic trypanosomes. 23. L2 larvae ol‘Ascaris lumbrz’eoides: hatch out of the egg in the soil. 1.
2. hatch out of the egg in the small intestine.
3. hatch out of the egg in the alveoli of the lung.
4. molt to L3 larvae in the small intestine.
5. form large racemose cysts in the brain.
24. Binding of malaria infected erythrocytes to the cerebral endothelium is a receptor—ligand mediath event; choose one among these combinations: Thrombospondin/Intercellular adhesion molecule.
CD3 6/Thrombospondin. *HRP/Thrombospondin *(HRP-histidine rich protein).
HRP/EMP—l (erythrocyte membrane protein).
CD36/Intercellular adhesion molecule. Wdergt‘ For each of the following multiple choice questions, choose the one correct or most
appropriate answer. 25. Recurrence of toxoplasmosis can result into serious complications in: 1. pregnant mothers sero—positive for toxoplasmosis.
2. lactating mothers sero~positive for toxoplasmosis.
3. young adults sero—positive for toxoplasmosis. 4. immunosuppressed individuals. 5. none of the above. 26. Cryptosporidium is a parasitic opportunistic organism. Which of the following factors
may contribute to the spreading of the infection in the population? 1. drinking milk.
2. allergies to dairy products.
3. using cattle manure as fertilizer.
4. eating raw meat.
5. all of the above.
27. Gravid segments in ccstodcs:
1. contain fully developed male and female reproductive organs.
2. are located just below the scolex.
3. contains ova in the uterus.
4. function as an organ of attachment to host intestinal wall.
5. none of the above.
28. Which one of the following cell—mediated immune mechanisms apply to invasive
amebiasis:
1. the host cell—mediated immune response is not affected in invasive amebiasis.
2. the abscess—derived macrophages can kill the trophozoites.
3. the abscess—derived neutrophils can kill the trophozoites.
4. the respiratory burst of abscess-derived macrophages is not affected.
5. none of the above.
29. Which one of the following Plasmodi'um falciparmn stages develop/differentiate in A rmphelt'ne mosquitos: 1. ring form.
2. merozoitc.
3. schizont. 4. trophozoite.
5. none of the above. 30. Entamaebn lits‘itolyticu: is an anaerobe and does not possess mitochondria.
preferentially colonizes the colon. cyst has 4 nuclei. cysts are produced only in the colon. all of the above. 9:“wa For each ofthe following multiple choice questions, choose the one correct or most
appropriate answer. 3 l. Stichocytes are present in: l. Ascaris lumbricoides.
2. Trypcmosoma cruzi.
3. Wuchereria bancmﬂi.
4. Cystieercus larva. 5. none of the above. 32. Plasmodiumﬁdelpamm schizont-elaborated pyrogen induces: 1. release of TNF—a from macrOphages and reticulo—enclothelial cells.
2. PfEMP—l antigenic variation on merzoites. 3. polyclonal activation of B and T lymphocytes. 4. l and 2. 5. l and 3. 33. During immune expulsion of Trichinella Spl'ralz's and Nippostrongyfus mum's from the
intestine, signal transduction and activation of transcription-6 is mediated by: 1. THE types of cytokines.
2. TH2 types of cytokines.
3. lFN—‘y
4. TFN—oz.
5. none of the above.
34. Which gn_e of these following inﬂammatory cells is known to provide the building blocks for ChareotnLeyden crystals? 1 . monoeyte.
2. neurophil.
3. macrophage.
4. epitheloid cell.
5. none of the above.
35. Malaria] paroxysrn (chill, fever and sweating) corresponds with E of the following events in the infected host: invasion of hepatoeytes by merozoites. invation of erythrocytes by merozoites. invasion of hepatocytes by sprozoites. rupture of erythrocytes containing the gametocyte stage.
none of the above. ensure—— 36. Cestodes lack one of the following features (organs): 1. gastro-intestinal tract.
2. nervous system. 3. month. 4. excretory system. 5. none of the above. For each of the following multiple choice questions, choose the one correct or most
appropriate answer. 37. Which one of the following is most commonly associated with the disease spectrum of
eysticercosis:
acute pulmenitis. I.
2. epilepsy of sudden onset.
3. intestinal obstruction.
4. obstruction of the respiratory tract.
5. acute diarrhea.
38. Which 9g of the following characterizes the chronic course of active hydatid disease in
humans:
1. depressed delayed hypersensitivity response.
2. depressed anti—hydated lgG response.
3. presence of Echinococcus granulosus ova in the stool.
4. presence of viable protoscolices in the stool.
5. anemia.
39. Parenehymatoas neurocysticercosis is caused due to the:
l. entrapment of oncesphere in the ventricles of the brain.
2. entrapment of adults Tacnia in the parenehyma of the brain.
3. entrapment of miraeidium larva in the parenehyma 0f the brain.
4. entrapment of oncospherc in the meninges.
5. none of the above.
40. In the list of helminth parasites given below, choose the 9113 that has onehosphcre larva in its life cycle: 1. Toxocam cams.
2. Schislosoma haematobium.
3. Taenia salium.
4. Schistosoma mansoni.
5. Ascarz's lumbricoides.
4]. ln Ascaris, the following clinical features are observed:
1. migration of larvae to the brain and epilepsy.
2. deposition of eggs in the eye by migrating larval parasites.
3. two phases involving larval invasion through the skin and adult worm migration in
“ ‘ ‘the tissues.
4. three phases involving infection in the lung, infection in the intestine and parasites
wandering in the tissues.
5. two phases involving wandering worms that migrate out of the skin into the eye. 42. Montinegro skin test is used for the diagnosis of: cutaneous/mueoeutaneous leishmaniasis.
Chagas’ disease. pneumocystosis. hepatic amebiasis. none of the above. P‘P‘P’Pt‘“ For each of the following multiple choice questions, choose the one correct or most
appropriate answer. 43. Natural resistance is: 1. any form of resistance that is based on mechanisms independent of acquired
immunity. mediated by cytokine-activated marophages. dependent on acquired immunity. the protective action of the intestinal mucosa. all of the above. $115393.“ 44. The subcellular organelle kinetoplast is found in members of the: 1. class Sporozoca.
2. Class Lobosea. 3. class Trematoda.
4 class Cestoidea. 5 none of the above. 45. Experimental evidence shows that C3b acts as opsonin and facilitates entrance of one of
the following organisms (or parasite stage) into the host cell: 1. amastigote stage of Leishmania into macrOphages/RE cells. 2 malaria sporozoite stage into reticuloendothelial (RE) cells. 3. le/‘pCIHOSOH‘Ia (:ruzz' trypomastigote into macrophages. 4 promastigote stage of Leishmania into macrophages/RE cells.
5 malaria merozoitc stage into erythrocytes. 46. in which one of the following parasites does ﬂ stages in the life cycle of the parasite occur
in the same host: 1. Wucher‘eria bancrqﬁi (lymphatic ﬁlarial).
2 Trichiriella Spfl‘alifS; 3. Leishmania donovani. 4 Plasmodizmz vivax. 5 None of the above. 47. Why do clinical diagnostic laboratories require at least three fecal specimens for the
diagnosis of parasitic diseases: 1 to make more money. 2 to increase the chances of identifying the origin of the source of infection. 3. to increase the chances of detecting helminth eggs only. 4 to increase the chances of detecting protozoa cyst and oocyst only. 5. to increase the chances of detecting helminth eggs, protozoa cysts and oocyst. SECTION II Each question in the following section consists of an assertion (statement) and a reason. as) 48. 49. 50. 51. 52. 53. 54. 55. Mark the card: if both the assertion and reason are true statements and the reason is a correct explanation
of the assertion. if both assertion and reason are true statements but the reason is NOT a correct explanation
Ofthe assertion. if the aSSertion is true but the reason is a false statement.
if the assertion is false but the reason is a true statement.
if both assertion and reason are false statements. DIRECTIONS SUMMARIZED 1. True True (reason is a correct explanation) 2. True True (reason is NOT a correct explanation)
3. True False 4. False T1116 5. False False Blocking antibody levels are higher in patients with symptomatic onehoeerciasis
BECAUSE they mediate delayed type hypersensitivity reaction. Retinochoroiditis is a serious manifestation of chronic toxeplasmosis BECAUSE even
healthy individuals harbouring toxoplasma pseudocysts generally show low levels of anti-
toxoplasma antibodies. Thymectomixed irradiated bone marrow reconstituted mice are used experimentally to
demonstrate the role of cell mediated reactivity in host defense to parasites BECAUSE
such mice are deﬁcient in accessory cells. Repture of tissue-oocysts of Toxoplasma gondt'i initiate recurrence of toxoplasniosis in
humans BECAUSE the oocyst stage of this parasite is found in human heart and human
brain tissues. Cytokines may play a role in the onset of pathology BECAUSE cytokines are involved
primarily in the immune response against infectious agents. Peripheral and tissue cosinophilia characterize the course of most helminth infections
BECAUSE eosinophils are specialized cells and they secrete high levels of both THl and
THE types ofcylokines. Plasmodimn fair-marina blood—stage merozoites are known to reinfeet hepatocytes
BECAUSE P. “falciz'parwn is known to persist in the liver of the infected host for many
years. There are some similarities in the life cycle of Plasmodi'um 3p: and Cryptospori‘di‘am 3p.
BECAUSE both these organisms have sporozoite and merozoite stages in their life cycle. Soil contamination with dog’s feces can contribute to the transmission of ascariasis
BECAUSE Ascarta lumbricoz‘des is transmitted by ingestion of embryonated eggs that
contain infective L2 larva. 57. 58. 59. 60. 61. 63. 64. 65. 66. 67. DIRECTIONS SUMMARIZED True True (reason is a correct explanation) True True (reason is NOT a correct explanation)
True False False True False False 9:59P?“ Rupture of a large unilocular hydatid cyst in a human host can be fatal BECAUSE the
release of large amounts of hydatid ﬂuid is known to cause severe allergic symptoms
(anaphylactic shock). Secretory products (GRA proteins) released by Toxoplasma tachyzoites are “protective” to
the parasite BECAUSE these secretory products localize at the inner face of the membrane
of parasitophorous vesicles and inhibit their fusion with the lysosomes. Ciyprosporz‘dium oocysts and G. lamblia cysts are major contaminants of surface water
BECAUSE oocysts and cysts are released in large numbers in fecal materials ofcattle. Encysted Tri‘c/zinella larvae are also found in the liver of infected hosts BECAUSE the
migrating larvae of Trichinella are known to encyst in the liver. The diagnosis of amehiasis can be made by demonstrating the typical cystic stage of
Entamoeba histolytiea in the feces BECAUSE the cystic stage of E. histolyrica can be
easily differentiated morphologically from E. coil cysts. Tumour necrosis factor (TNF) is believed to be one of the critical mediators of malaria
fever BECAUSE low serum TNF levels in malaria infected individuals have been shown
to correSpond with the fever peak. Concentration methods used for fecal processing prior to microscopic examination
increases the chance of detecting reproductive stage(s) of the parasite in the sample
BECAUSE the concentration method like the formal — either method eliminates much of
the unwanted 'l‘ecal debris. Certain "PH—2 derived cytokines play a central role in eosinophilopoiesis BECAUSE IL—S
stimulates the eosinophil progenitor cells in the bone marrow to attain maturity. Taenia .s‘olmm can cause both taeniasis and neurocysticereosis in humans BECAUSE the
adult T. solimn tapeworm can reside both in the intestine and the brain. The calcareous corpuscles (cc) are one of the important histological landmarks in the
mesenchymal tissues of ecstodes BECAUSE under light microscopic examination, cc
present a characteristic histological feature. Aboriginals (Inuit and Native Canadians) show a relatively high incidence of hydatid
infection as compared to the urban population BECAUSE the former accidentally acquired
infection by ingesting undercooked liver herbivores (ungulates) infected with hydatid cysts. 68. 69. 70. 7]. 72. 73. 74. 75. DIRECTIONS SUMMARIZED 1. True True (reason is a correct explanation) 2. True True (reason is NOT a correct explanation)
3. True False 4. False True 5. False False Enramoeba liistotvtica trophozoites found in biopsied tissue sections can be easily
differentiated from neutrophils BECAUSE their nuclear structures are morphologically
distinct. I Hemoglobineuria is one of the sequela of acute haemolytic anemia in falciparum malaria
BECAUSE this condition is believed to be associated with the failure of the host to
generate anti~RBC IgM antibodies. Presently there is no efficacious therapy against cryptosporodiosis BECAUSE the
effectiveness of the drugs available require an efﬁcient immune response. Microtrichcs are important structural features of the cestode gastro—intestinal canal
BECAUSE mierotriches increase the surface area of cestode tegument available for
absorption ol‘nutrients. Trichinclla spiralis is not considered as a typical nematode BECAUSE this species happens
to be the largest intracellular parasite. Secretory products from Rhoptry and toxoneme released from the infective stages of
Plasmoditmt and Toxopiasma are involved in host cell invasion BECAUSE these secretory
products induce perturbation in the host cell plasma membrane and facilitate entry of the
parasite to the target cells. The incidence of Toxop/asma transplancental transmission to the fetus is relatively high
during the third trimester if the mother acquires primary infection with Tompkisz
BECAUSE Toxopi’asma infection can also be acquired by Toxoplasma oocyst. Degranulation of eosinophils at tissue sites are believed to modulate immediate
hypersensitivity reaction (IHR) induced by mast cell degranulation BECAUSE eosinophil—
derived factors are known to neutralize some of the chemical mediators of IHR. SECTION III For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: 76. 77. 78. 79. 80. If A and B are correct Mark 1
If A and D are correct Mark 2
if A. B and C are correct Mark 3
If B is correct Mark 4
If E is correct Mark 5 Progression ofclinical pathology in lymphatic ﬁlariasis involves: enow> an asymptomatic incubation phase. an obstructive phase involving blockage of the lymphatic duets. an inﬂammatory phase involving release of microﬁlaria in the lymph ducts.
inﬂammation of the liver and lymph nodes. a 24 hour fever cycle corresponding to microﬁlaria migration into the bloodstream
at night. Which of the following statements are correct with respect to the ovum of Echinococcus. .0150??? they are highly resistant to cold temperature and ordinary disinfectants. they are the source of infection for both man and herbivores. they can be demonstrated in the tissues of hydatid patients. they hatch in moist soil and humans acquire infection by percutaneous route.
they can be demonstrated in the feces of hydatid patients. Malarial neprhosis called “nephrotic syndrome" in humans: mace? is caused by Plasmodium malariae. is an immune complex mediated disease. does not respond to malarial therapy. is caused by Plasmodium vivax. is caused by the invasion of merozoites t0 the kidney glomerular capilliarics. Lymphatic ﬁlariae include the following species: P150931? Wuchcreria bancrofti.
Onchoeerca volvulus.
Mansonella species.
Brugia rnalayi. Loa loa. Human infection with Ascaris is associated with: an increased response by PBMCs to Ascaris antigens. an increased frequency of PBMCs producing 1L4 and 1L5. an increased ratio of 1L4 to IFN 7 produced by PBMCs in response to Ascaris
antigen. an overall induction of a Th0/ 1 like environment. a decreased ratio of Th2 to Th1 PBMCs. For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: If A and B are correct Mark 1
If A and D are correct Mark 2
HA, B and C are correct Mark 3
If B is correct Mark 4
If E is correct Mark 5 81. The pathogenicity of virulent Entamoeba histolytica act via the following mechanisms(s): the trophozoite must adhere to the host cell to be cytotoxic. the trophozoites may secrete a protein called amoebapore. the trophoxoites interfere with the activity of disaccharidases. the trephozoites must be able to encyst in the intestinal lumen. the trophozoites chemically modify the mucus content of the large bowel. menu? 82. The course of clinical malaria in the susceptible pepulation living in an area endemic for
malaria, is quite variable and is dependent on the: A. species of Plasmodium involved. B. host’s genetic factors. C. history of prior exposure and duration of the infection. D. host’s sex. E. number of sporozoites inoculated by male anopheline mosquitoes. 83. Charcot—Leyden crystals are formed from the eosinophil—derived: major basic proteins.
lysophospholipase.
eosinOphil—den'ved neurotoxin.
eosinophil-derived cationic protein.
none of the above. moon? 84. Trichinosis is associated with multiple alterations in the host’s humoral immunity: serum IgG and IgM levels are elevated.
serum IgD level is elevated. serum IgA level is elevated. gut IgA level is elevated. none of the above. muow> 85. Polysulfated polysaccharide synthesized by cysticerci: A. is anticomplementary in nature. B. covers only the bladder portion of cystieerci. C. inhibits the binding of inﬂammatory cells to the tegument of cysticerci. D. speciﬁcally promotes antibody—dependent cell cytotoxicity mechanism agains
eystieerci. E. covers only the seolex of cystieerci. For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: 86. 87. 88. 89. 90. If A and B are correct Mark 1
If A and D are correct Mark 2
If A, B and C are correct Mark 3
If B is correct Mark 4
If E is correct Mark 5 The leishmania mitochondrion is the site of which of the following. A. LPG. B. Kinetoplast.
C. Glyoxosome.
D. VSG. E. GP63. in human W bancrofti infection, blocking antibodies have the following properties: they are of the lgG4 isotype. they are found at higher levels in patients who are infected but asymptomatic. they block parasite invasion into the lymph gland. they are found at higher levels in patients who are symptomatic with chronic
disease. 13. they always have the same speciﬁcity as lgM antibodies. wow> Trickirzeir’a Spirafz's: is a nematode. has the capacity to adapt to a variety of hosts.
is classiﬁed under the phylum Platyhelminthes.
adults usually parasitize colon mucosa. does not exist in Canada. meow? EosiriOphil-derived major basic protein (MBP): acts as helminthotoxic molecule. acts as a neurotoxin. is located in the matrix of the eosinophil granule.
forms the crystalline core of the eosinophil granule.
has an isoelectric pl-l (pi ) value of 3. wpowa Immune correlation studies in human schistosomiasis have discovered that: A reinfection is positively associated with lgM responses to parasite antigens.
B reinfection is positively associated with IgG titres to parasite antigens. C. lower IgE titres are observed in resistant individuals. D reinfection is negatively associated with lgG titres to parasite antigens. E reinfection is negatively associated with lgM responses to parasite antigens. For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: 91. 92. 93. 94. If A and B are correct
If A and D are correct If A, B and C are correct If B is correct
le is correct Mark 1
Mark 2
Mark 3
Mark 4
Mark 5 The immunological phenotypes involved in resistance to infection and disease in human
schistosomiasis included: meow? T. bmcez‘ levels in the bloodstream initially go down because: The cellular immune response effectively remove the parasite
Anti—VSG antibodies effectively remove the parasite
Anti—LPG antibodies effectively remove the parasite The parasite enters into the central nervous system The parasite dies off. mcow> Following removal from the blood stream, high T. brucer‘ levels return to the a Th0/2 like response determining low worm burdens. a response involving low levels of IL4 determining low worm burdens. a response involving high levels of IFN 'ydctermining low worm burdens.
a ThO/ 1 like response determining low ﬁbrosis in the liver. a suppressor ThO response that suppresses both infection and subsequent liver fibrosis. bloodstream because.
The person usually can be re'infected.
T. bmcei has switched to a new VBSG which are not recognized by the existing A.
B. C.
D.
E VSG antibodies. The person becomes immunosuppressed. The T. brueei differentiates to the epimastogote form. The T. brzrcei becomes more virulent. In humans resistant to schistosomiasis, there is: A. B.
C.
D positive association between lgG responses to schistosome antigens infection. no relationship between development of immunity and age.
positive association between lgM responses to schistosome antigens infection. negative association between IgE responses to schistosome antigens infection. no association between antibody responses to schistosome antigens infection. and and and and [‘6- re— For each of the questions or incomplete statements below ONE or MORE ol‘ the suggested
answers or completions are correct: 95. 96. 97. 98. 99. if A and B are correct Mark 1
If A and D are correct Mark 2
If A, B and C are correct Mark 3
MB is correct Mark 4
If E is correct Mark 5 Immune effector mechanisms active against Schistosoma include: antibody-dependent killing of schistosomula but not adult worms.
IgE dependent killing mediated by eosinophils. lgG dependent killing mediated by macrophages. lgM dependent killing mediated by eosinophils. lgG dependent killing mediated by NK cells. eves? Patients successfully treated against Kala—azar (visceral leishmaniasis) manifest in due
course: a positive leishmanin or Montenegro skin test hypersensitivity reaction.
“regeneration” of TlllCD4+ cell activity. a negative tuberculin skin test hypersensitivity reaction. heightened resistance to bacterial / fungal infection. decreased IL-4 and IL-10 production by B—cells. meow? Evidence for the importance of immunity in giardiasis comes from the following sources: A. an increased incidence of clinical giardiasis is seen in visitors to an endemic area as
compared to the local population. 13. chronic (Hardin infection is observed in athymic laboratory mice or in chemically
immunosuppressed mice. C. an increased prevalence of Giardia infection is seen in immunologically compromised individuals.
serum anti-Giardia antibody levels are elevated in the infected patients.
Giardia surface antigens are excellent immunogens. we identify the correct statement or statements concerning cysticereosis: A. it can occur through the ingestion of Taenia solium ova in contaminated food or
drink.
B. it can occur due to reverse peristalsis pushing Taenia solium ova from the intestine to the stomach.
C it can occur as a result of auto—infection in patients with Taeniasis.
D. it can occur by eating beef containing cysticercus larvae.
E it can occur by eating fresh water fish containing cysticercus larvae. Gene conversion is used by: Leishnmnin to express different LPG molecules.
L. drmovam' to control gene expression.
Lefshmania to carry out RNA editing. T. brucei to express different SSG genes. 1". brucei to early out transplieing. moose For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: 100. lOl. 102. 103. 104. If A and B are correct Mark 1
If A and D are correct Mark 2
If A, B and C are correct Mark 3
If B is correct Mark 4
HE is correct Mark 5 Diffuse cutaneous leishmaniasis is a distinct clinical entity and is characterized by the
following features: the lesions are nodular and do not ulcerate. the lesions show superahundance of leishmania parasites in skin macrophages.
the leishmanin Type—4 skin reactivity is positive. the parasite metastasizes from the skin to the soft organs. the lesions show rare leishmania parasites in skin macrophages. ecow> Aldara (imiquimod) may be a useful new drug to treat leishmaniasis because it can: Activate macrophage phagocytosis. Activate macrophages by binding the T011 7 receptor
Directly kill amastigotes Directly kill promastigotes Reverse the drug resistance phenotype momma Alveolar type of hydatid disease in humans is caused by: A. the proliferation and metastasis of'unilocular hydatid cysts in soft organs. B the presence ol‘large numbers of adult Echinccoccus nmltilocularis in the intestine
of man. C the migration of onchosphere larvae in the soft organs. D. the larval (metacestode) stage of E. gmmu’osus. E. the larval (metaeestode) stage of E. multi'loculari's. Hydrocephalus in neurocysticercosis is associated with the: location of racemosus cysticerci in the brain ventricles.
location of racemosus cysticerci in the sub—arachnoid space.
location of racemosus cysticerci in the brain parenchyma.
location of racemosus cysticerci in the durameter. location of racemosus cysticerci in the sub—cutaneous tissues. P100513? Ct‘sticer‘cus r‘r'ici'en-i.()sus: is an atypical Cysticercus larva.
lacks a scolex. measures several feet in length. is a cystic form of Cysri'cercus larva.
possesses an acetabulate scolex. FEST/MOW? For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: [05. 106. 107. 108. 109. If A and B are correct Mark 1
lf A and D are correct Mark 2
HA, B and C are correct Mark 3
If B is correct Mark 4
If E is correct Mark 5 Which of the following adult parasites produce larvae instead of eggs in the host: A.
B.
C.
D.
F Ascaris lumbricoides.
Taem'a. s01 rum.
Ec'liinoeoccus multilocularis.
Schistosoma nzansoni.
Trickinclla Spiralis. Some of the features of a Toxocara infection are: A.
B. C.
D.
F a systemic migration of larvae in humans. direct infection by ingestion of infective larvae in aerosols released by infected
dogs. inﬂammation of the eye in humans due to deposition of eggs by migrating larvae.
inﬂammation of the eye in humans following ocular invasion by larvae. a systemic migration of adult worms in humans. Genetics studies in humans have found signiﬁcant evidence for genes linked to resistance
to schistosomiasis, including: com? F“ a gene on chromosome 1p22.2 determining resistance to infection. a gene on chromosome 5q3 l—q33 determining resistance to infection. a gene on chromosome 6qZ2—q23 determining resistance to liver fibrosis. a gene on the X chromosome determining increased resistance in females around
the age of puberty. a gene on chromosome 16q22-q23 determining resistance to liver ﬁbrosis. In patients with hydatid disease acquired in Canada, the unilocular hydatid cyst
preferentially (about 80—90%) localizes to: meow> right lobe of the liver.
kidney. bone marrow.
subcutaneous tissues.
lungs. ln Leishmania, mitochondrian transcripts must undergo which process in order to be functional: A. RNA stabilization through the 3’ UTR.
B. Trans—splicing. C. Cis-splicing. D. RNA editing. E. Gene conversion. For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: lfA and B are correct Mark 1
If A and D are correct Mark 2
if A, B and C are correct Mark 3
lfB is correct Mark 4
HE is correct Mark 5 l 10. THl cellular immune response is important to resolve which kind of infection: A
A. all Trypanosome infections. B. L. nmjor infection, but not L. Donovani infection.
C. L. donovani infection, but not L. major infection.
D. All Leis-lumen: infections. L‘ T. br‘ucei infections. 111. In children infected with Toxocara, ultrasound has been used to: conﬁrm serological diagnosis by ELISA. confirm infection in asymptomatic children. identify lesions in the heart and lung. conﬁrm lesions in the brain due to aberrant larval migration.
identify migrating adult worms in the liver. noon? 1 12. Casoni test: is used for the diagnosis of schistosomiasis. is used for the diagnosis of hydatid disease. is used for the diagnosis of neurocysticcrcosis. is used for the diagnosis of Visceral Larva Mi grans.
is used for the diagnosis of hepatic amebiasis. P153095? 113. The macrophage protein kinase C (PKC) enzyme is inhibited by which parasite molecule: A. T. brucei. B. Leishmania LPG. C. Leishmania A2. D. T. brucei phosphatase.
E. T. bmcei kinase. 114. Which one or a combination of the procedures described below is/are used for the
diagnosis of neurocysticereosis: CT scan (brain imaging). histological examination of the biopsied sample from the brain.
Western blotting. microscopic examination of the cerebrospinal fluid. none of the above. spews For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: If A and B are correct Mark 1
if A and D are correct Mark 2
If A, B and C are correct Mark 3
If B is correct Mark 4
if E is correct Mark 5 l 15. Entamoeba despar A. cysts have eight nuclei. B. was proposed by Brumpt to designate the non-pathogenic strain of Entamoeba
histolytica. C. cysts dimensions are similar to Enlamaeba colt cysts. D. cysts dimensions are not similar to Entamoeba histolytica cysts. E. cyst may have more than four nuclei. 1 16. During the life cycle of prtosporidimn parvum merozoitcs attach to the brush border of epithelial cells.
schizogony precedes the development of merozoites.
microgametes and macrogametes are not generated.
sporozoitcs attach to the mucus present in the small intestine.
four nierozoites are released at the rupture of the oocyst. FSQW? l 17. Hemoglobin (Hg) “ingested” by the early erythrocytic stages ofPlasnma’ium sp: A. is completely degraded into its constituent amino acids in the lysosomes. B. eventually polymerises into hemozoin granules in the lysosomes. C. remains stored in the lysosomes and following exocytosis contributes
to hemoglobinemia. D. is partially degraded into the lysosomes where the globin moiety polymerizes
into hemozoin granules. E. is partially degraded into the lysosomes where the heme moiety polymerizcs into hemozoin granules. l 18. L. donovcmi predominantly causes which kind of disease: cutaneous leishmaniasis. visceral leushmaniasis.. mucocutaneous leishmaniasis. both cutaneous and visceral leishmaniasis.
mucocutaneous and cutaneous leishmaniasis. mDOW? l 19. Ee/iinocacc'us protoseoliees: are morphologically similar to the adult Echinococcus. have the potential to deveIOp into adult Echinacaccus in carnivores. released in the peritoneal cavity during surgery, can develop into new hydatid cysts.
can survive for months in moist soil. ingested with undercooked sheep liver, can develop into adult Echinococcus in
humans. ECO??? For each of the questions or incomplete statements below ONE or MORE of the suggested
answers or completions are correct: HA and B are correct Mark 1
HA and D are correct Mark 2
If A, B and C are correct Mark 3
If B is correct Mark 4
If E is correct Mark 5 120. Taem'a so/r'um ova are morphologically similar to that of: Acaris lumbricoides ova.
Echinococcus sp ova
Schistosoma sp ova.
Entamoeba coli cysts.
Toxocara ova. Ppom> ...
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